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Percutaneous Interventions for Structural Heart Disease pp 295–306Cite as

Percutaneous Repair of Post-myocardial Infarction Ventricular Septal Rupture

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Abstract

Post-myocardial infarction ventricular septal rupture (VSR) is one of the most serious complications occurring in patients with ST elevation myocardial infarction. Although surgical repair with concurrent coronary artery bypass grafting (CABG) is considered the treatment of choice, it carries a very high morbidity and mortality rates. For this reason, surgical approach to all patients might not be reasonable, in particular when patients are critically ill or with multiple comorbidities. Percutaneous interventional approach appears to be safe and effective in patients with a chronic VSR or treated for a residual shunt after initial surgical closure. Immediate primary transcatheter closure in acute setting may also be considered an alternative and effective strategy in selected patients ensuring greater effectiveness and fewer complications compared to surgery. The timing of surgical or percutaneous intervention is critical: the presence of cardiogenic shock and closure in the acute phase after VSR diagnosis are important risk factors of mortality. Due to the high mortality rate, the use of percutaneous occluders has been investigated as an alternative approach. The treatment with dedicated device is in general successful with few procedure-related complications. This strategy is a less invasive alternative to surgical approach; however it needs to be applied on a case-by-case basis.

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Acknowledgments

The authors thank Anteo Masciotra, Raffaella Ciummo, and Paola Viglione for the technical support and their assistance with the images acquisition.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Tor Vergata University of Rome, Rome, Italy

    Francesco Versaci MD, FACC & Francesco Romeo

  2. Department of Cardiovascular Disease, Ospedale “Antonio Cardarelli”, Contrada Tappino, 86100, Campobasso, Italy

    Antonio Trivisonno & Giampiero Vizzari

  3. Department of Cardiovascular Disease, Ospedale “San Giovanni-Addolorata”, Rome, Italy

    Francesco Prati

  4. Department of Cardiovascular Disease, Ospedale “Giovan Battista Grassi”, Rome, Italy

    Anna De Fazio

  5. Department of Cardiovascular Disease, Ospedale “Ferdinando Veneziale”, Isernia, Italy

    Carlo Olivieri

Authors
  1. Francesco Versaci MD, FACC
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  2. Antonio Trivisonno
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  3. Francesco Prati
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  4. Anna De Fazio
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  5. Carlo Olivieri
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  6. Giampiero Vizzari
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  7. Francesco Romeo
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Corresponding author

Correspondence to Francesco Versaci MD, FACC .

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Editors and Affiliations

  1. Department of Cardiology, Mirano Hospital, Mirano, Italy

    Bernhard Reimers

  2. Cardiac and Endovascular Interventions, First Coast Cardiovascular Institute, Jacksonville, Florida, USA

    Issam Moussa

  3. Department of Cardiology, Mirano Hospital, Mirano, Italy

    Andrea Pacchioni

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Versaci, F. et al. (2017). Percutaneous Repair of Post-myocardial Infarction Ventricular Septal Rupture. In: Reimers, B., Moussa, I., Pacchioni, A. (eds) Percutaneous Interventions for Structural Heart Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-43757-6_25

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  • DOI: https://doi.org/10.1007/978-3-319-43757-6_25

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43755-2

  • Online ISBN: 978-3-319-43757-6

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